Medical Director, Santé Health System, Inc

Medical Director Vice President, Physician Services

Job Summary:

The Medical Director for ______is primarily accountable for continuously improving the quality of medical care delivered by XYZ Company while ensuring that care is delivered in the most efficient manner possible. This position is also responsible for the design and implementation of education and wellness programs for this physician group and their patients. As Vice-President, Physician Services, this position serves as the liaison for quality and cost-effectiveness initiatives between XYZ Company and ______Hospital. Major Duties and Accountabilities:

1. Serves as a senior member of the Management Team in support of XYZ and other their clients.

2. Works with the management and the Hospital Board to develop and implement the medical budget and operating policies of XYZ.

3. Attends the following XYZ Board and committee meetings:

Board of Directors Finance Committee Executive Committee Quality Improvement Credentialing Specialist Advisory Primary Care Advisory Professional Affairs Board Committee (as requested) Other meetings with providers and boards as necessary

4. Prepares presentations in support of IPA Board and committee meetings

5. Plans and coordinates the activities of assistant medical directors

6. Works with XYZ providers, Board and MSO management to develop utilization benchmarks by specialty, revising and challenging benchmarks on a regular basis

7. Works with XYZ providers to ensure they understand utilization reports

8. Communicates the results of utilization management activities to XYZ providers, management and the Board 9. Develops systems to streamline utilization and referrals

10. Works with the XYZ Board to implement appropriate financial incentives for providers

11. Develops and implements the educational plan to include professional and wellness education

12. Coordinates IPA utilization management with various hospitals in the system.

13. Works with staff in the development and enhancement of practice guidelines

14. Meets regularly with contracting health plans

15. Coordinates new HMO requirements throughout the MSO and Hospital network

16. Develops a Pharmacy Utilization Program

17. Obtains delegated credentialing status from the Health Plans and facilitate the credentialing and recredentialing process for all XYZ physicians

18. Documents activities and their related impact on the Hospital and XYZ and reports this on a regular basis to the Executive Director of the MSO and the Sr. Vice-President for Physician Services

19. Works with the IPA and Hospital Boards to ensure good relations

Reporting Relationships

This position reports to the Sr. Vice-President, Physician Services, for the coordination of medical services between XYZ Physicians and ______Hospital.

This position reports to the Executive Director of XYZ for non-medical administrative services performed on behalf of the Physicians.

This position reports to the Board of Directors (or applicable committee as assigned) for the medical related services performed on behalf of XYZ.

Works with or supervises: credentials coordinator, physician services coordinator, wellness coordinator, quality improvement coordinator, assistant medical directors and administrative assistant. Minimum Qualifications

M.D. or D.O. degree with current medical license (or able to obtain prior to employment). Five years of practice experience in an outpatient setting. Two years of experience in a part-time management role in a heavily penetrated managed care environment.

Preferred Qualifications

Board certification in a primary care specialty. Master’s degree in business or health care management with additional training in medical administrative areas.

Performance Measurement Criteria:

1. Supervisors, staff and peer feedback

2. Adoption of a management and communication style which facilitates team activities

3. Completion of additional education related to job duties

4. Annual review of budget performance in areas of direct accountabilities

5. Objective criteria developed and met for achieving utilization benchmarks and cost-efficiencies

6. Physician satisfaction surveys

7. Active participation in committee and task forces

Successful annual implementation of two additional clinical practice guidelines